{"paper_id":"0c4af366-24a8-4d2e-83c0-8c0bd61bab13","body_text":"Abstract\nObjective Sleep and cancer are intricately interconnected. We used a nationally representative sample to study the effect of sleep duration on cancer incidence and prognosis, aiming to propose an optimal sleep duration and generalize it to community populations.\nMethods Data from participants aged ≥18 years in the National Health and Nutrition Examination Survey (NHANES, 2005-2018) were analyzed (n=37,338). Self-reported sleep duration was analyzed alongside mortality data from the National Death Index as of 12/31/2019. Primary outcomes included all-cause mortality, cancer-specific mortality, and non-cancer mortality. Odds ratios (OR), hazard ratios (HR), and corresponding 95% confidence intervals (CI) were calculated using logistic regression and Cox proportional hazards regression, respectively. Restricted cubic spline (RCS) analysis was used to explore potential non-linear associations.\nResults The prevalence of cancer was 10.12%. After adjusting for confounders, >7 hours of sleep was strongly associated with an increased OR for cancer incidence (1.18 (1.04,1.33) for (7-8] and 1.54 (1.28,1.86) for (8-14.5]). During a median follow-up of 6.1 years, 341 cancer-related deaths and 661 non-cancer-related deaths occurred. fully adjusted models, compared with 7 hours of sleep, >7 hours of sleep significantly increased the HR of all-cause mortality (1.40 (1.06,1.84) for (7-8] and 1.90 (1.42,2.54) for (8-14.5]); cancer mortality (1.20 (0.77,1.87) for (7-8] and 1.70 (1.05,2.73) for (8- 14.5], 1.70 (1.05,2.73)) and non-cancer mortality (1.50 (1.07,2.12) for (7-8], 2.03 (1.42,2.90) for (8-14.5]). Stratified analysis, RCS analysis and sensitivity analysis yielded consistent results.\nConclusions This study suggests that the optimal sleep duration should be 7 hours, as excessive sleep may increase cancer risk and mortality risk in cancer survivors. Our findings should be useful for health education and promotion in primary care and clinical practice.\nCompeting Interest Statement\nThe authors have declared no competing interest.\nFunding Statement\nThe author(s) received no specific funding for this work.\nAuthor Declarations\nI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.\nYes\nThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:\nThe research protocol received approval from the Institutional Review Board of the National Center for Health Statistics (NCHS)\nI confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.\nYes\nI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).\nYes\nI have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.\nYes\nData Availability\nThe data used for all analyses are sourced from the public database NHANES, available at:[https://www.cdc.gov/nchs/nhanes/index.htm].","source_license":"CC-BY-4.0","license_restricted":false}